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A yellow flower known for its medicinal properties, including the words "St. John's Wort" written on it.

The Herbal Supplement That Rivals Prozac

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Flower Power: St. John’s Wort’s Drug-Level Effectiveness

St. John’s wort is a small yellow flower, extract of which can be bought inexpensively off-the-shelf in pretty much any pharmacy in most places.

It’s sold and used as a herbal mood-brightener.

Does it work?

Yes! It’s actually very effective. This is really uncontroversial, so we’ll keep it brief.

The main findings of studies are that St. John’s wort not only gives significant benefits over placebo, but also works about as well as prescription anti-depressants:

A systematic review of St. John’s wort for major depressive disorder

They also found that fewer people stop taking it, compared to how many stop taking antidepressants. It’s not known how much of this is because of its inexpensive, freely-accessible nature, and how much might be because it gave them fewer adverse side effects:

Clinical use of Hypericum perforatum (St John’s wort) in depression: A meta-analysis

How does it work?

First and foremost, it’s an SSRI—a selective serotonin reuptake inhibitor. Basically, it doesn’t add serotonin, but it makes whatever serotonin you have, last longer. Same as most prescription antidepressants. It also affects adenosine and GABA pathways, which in lay terms, means it promotes feelings of relaxation, in a similar way to many prescription antianxiety medications.

Mechanism of action of St John’s wort in depression: what is known?

Any problems we should know about?

Yes, definitely. To quote directly from the National Center for Complementary and Integrative Health:

St. John’s wort can weaken the effects of many medicines, including crucially important medicines such as:

  • Antidepressants
  • Birth control pills
  • Cyclosporine, which prevents the body from rejecting transplanted organs
  • Some heart medications, including digoxin and ivabradine
  • Some HIV drugs, including indinavir and nevirapine
  • Some cancer medications, including irinotecan and imatinib
  • Warfarin, an anticoagulant (blood thinner)
  • Certain statins, including simvastatin

Click here for a more comprehensive list of interactions, contraindications, and potential side effects

I’ve read all that, and want to try it!

As ever, we don’t sell it (or anything else), but here’s an example product on Amazon.

Please be safe and do check with your doctor and/or pharmacist, though!

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